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NPI Code Detail

MEDICARE: MICHAEL ADU-TUTU DDS

MEDICARE:   MICHAEL  ADU-TUTU  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistD2934AZ
2122300000XDentistDN10216FL
3122300000XDentist56698CA
4122300000XDentistDS0000004304TN

Other Identifiers

General Provider Information

NPI Number : 1952362931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ADU-TUTU DDS
Provider Business Mailing Address
First Line : 5150 NW MILNER DR
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34983-3392
Country : US
Telephone Number : 772-462-3874
Fax Number : 772-462-3874
Provider Business Practice Location Address
First Line : 714 AVENUE C
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-4189
Country : US
Telephone Number : 772-462-3874
Fax Number : 772-462-3880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2006
Last Update Date : 01/27/2014

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Directions to “ MICHAEL ADU-TUTU DDS” Practice Location

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